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It is Not Too Late! You Can Still Get Health Insurance for 2016

Updated on December 18, 2015

You may have heard that the deadline to get Obamacare on the first of the year has passed. However, if you have put it off, you can still get health care for most of 2016. Anybody who enrolls after 12/17/16 and before 1/31/2016 will have coverage beginning 2/1/2016. The dates and deadlines for getting health insurance can be found here.

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What is the penalty for not having health insurance?

If you decide to skip on the health insurance in 2016, you will be fined when you file your taxes for the year. The projected fine for 2016 could run up to $969 per household, and it is set up to increase each year. Healthcare.gov allows you to shop for the best deal available to you according to your income. Due to the subsidies the government is offering, it may be just as costly for some people to get health insurance as it is to go without it.

Hopefully you have decided to comply with the government’s rules and possibly save some money on your health care in the process, but you still have to choose a health plan. This can be daunting, but the healthcare.gov website narrows down your choices for you when you answer the first few questions on the site. They ask you what kind of coverage you need (such as individual or family), where you are located and how much you expect to make this year. They will not ask for personal information until after you have decided which plan you want to purchase. The information you give them will eliminate the plans you are not qualified for, but you will still end up with quite a few plans to sift through.

definitions for widely used health insurance terms
definitions for widely used health insurance terms | Source

What do I have to know when I apply for health insurance?

Before signing up, knowing the answer to the following questions will make your choices easier.

  1. How much do you expect to make next year? You will need to know this in order for the system to accurately estimate your subsidies. If you are wrong, you may end up paying more at tax time.
  2. How much do you expect next year’s medical costs to be? Just a rough estimate will be close enough. Nobody can predict the future. Do you have a surgery coming up or do you have medications that you know are expensive? Do you have young children?
  3. How much can you afford to spend per month for your premium? If your answer to the above is none, you have a lot of company! The premiums have a range of roughly $200 to $500 a month depending on your situation.
  4. Do you expect to reach your deductible and/or out of pocket max? If so, you may want to look at a plan with a higher premium and a lower deductible.
  5. Do you need a multi-state plan? If you do, just keep this in mind, not all insurance plans will cover multiple states. You will be able to find this information in the plan description.

There are four metals used to describe the different tiers of plans: Platinum, Gold, Silver, and Bronze. These tiers basically describe how much you will end up paying overall for your coverage. For instance:

Platinum covers 90% of your costs with a high premium and low deductible and coinsurance costs.

Gold covers 80% of your costs and generally have high premiums, low deductibles and low coinsurance options.

Silver covers 70% of insurance costs and generally have moderate premiums, low deductibles and moderate to high coinsurance options.

Bronze covers 60% of costs and generally have lower premiums with higher deductibles and moderate to high coinsurance options.

There is an additional tier of plans at the Catastrophic level. You may have heard of these plans because they have the lowest monthly payments. You have to be under 30 with a lower income to qualify for them. There is no government subsidy offered for these plans, but they are attractive to qualified individuals who do not expect to go to the doctor during the year. If you qualify for this type of plan (and if they are offered in your area) they will show up in your search results on healthcare.gov. Catastrophic plans cover anywhere from 0 - 60% of your health care costs.

Options for Choosing a Plan Based on Insurance Usage

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Why should I buy health insurance?

There are many different opinions about Obamacare. I can’t tell you what is best for you. I do know that the health insurance industry relies on the fact that everybody is involved. With the rising costs of healthcare, there are some healthy people that are willing to opt out. If every healthy person does that, the insurance companies will end up only paying for the sick people and will not be able to stay in business. So, you can think of purchasing health insurance as something you are doing to benefit the community as a whole. Keep in mind that health insurance has saved many a family from financial ruin. These families are grateful for your participation.

In return for our premiums, health insurance companies do give back. Having health insurance is like having a ticket to see the doctor. Some doctors will not see you unless you have insurance. If you use the doctors in your insurance provider’s network, there may be a substantial cost savings on services received. Also, because of the Affordable Care Act (otherwise known as Obamacare), you will be able to see the doctor for preventive services and screenings at no charge. They use the information you get on these visits to help you stay healthy. Depending on the results of your screenings, they may connect you with free programs that teach you how to manage certain health conditions and stay out of the doctor’s office as much as possible.

Congratulations!

Now that you know the basics, you can go to healthcare.gov and get started. Don’t forget to keep your banking information handy! You will have to make a payment right away to ensure that you have your coverage when you are supposed to. It may comfort you to know that you can shop for health insurance in your pajamas (with a beverage of choice) as you decide how much money you want to spend on 2016’s healthcare costs.

2016 Marketplace Application Walkthrough

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